Nokea
Jose is a 4-year-old child scheduled for a cardiac catheterization. What should be included in preoperative teaching?
- A. Directed at his parents because he is too young to understand
- B. Detailed in regard to the actual procedures so he will know what to expect
- C. Done several days before the procedure so that he will be prepared
- D. Adapted to his level of development so that he can understand
Correct Answer: D
Rationale: Preoperative teaching for Jose, a 4-year-old child, scheduled for a cardiac catheterization should be adapted to his level of development so that he can understand. Children at this age have limited cognitive and emotional understanding, so using simple language, visuals, and play-based strategies is essential. It is important to provide age-appropriate information to reduce anxiety and improve cooperation during the procedure. Preoperative teaching should focus on preparing Jose for what he will see, hear, and experience in a way that is tailored to his developmental stage. Involving play tools such as medical play dolls or child-friendly illustrations can help Jose grasp the concept of the procedure and alleviate fears. It is important to involve both Jose and his parents in the teaching process to ensure they understand how to support and prepare him for the procedure.
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Rickets is caused by a deficiency in:
- A. vitamin A.
- B. vitamin C.
- C. vitamin D and calcium.
- D. folic acid and iron.
Correct Answer: C
Rationale: Rickets is a condition that primarily affects children and is characterized by softening and weakening of the bones, leading to skeletal deformities. This condition is caused by a deficiency in vitamin D and calcium. Vitamin D helps the body absorb calcium from the diet, and together they play a crucial role in bone health and development. Without enough vitamin D and calcium, the bones cannot mineralize properly, resulting in the characteristic symptoms of rickets. Other nutrients like vitamin A, vitamin C, folic acid, and iron do not directly cause rickets.
The Andrews family has been taking good care of their youngest, Archie, who was diagnosed with asthma. Which of the following statements indicate a need for further home care teaching?
- A. "He should increase his fluid intake regularly to thin secretions."
- B. "We'll make sure that he avoids exercise to prevent attacks."
- C. "He is to use his bronchodilator inhaler before the steroid inhaler."
- D. "We need to identify what things trigger his attacks." 50
Correct Answer: B
Rationale: It is important to note that exercise should not be completely avoided for a child with asthma. Regular physical activity is beneficial for overall health and can help improve lung function in asthmatic individuals. Supervised and controlled exercise under the guidance of healthcare providers can be safe for children with asthma. Avoiding exercise altogether can lead to deconditioning and other health issues. It is important to educate the family on the proper management of asthma during exercise, such as using a rescue inhaler before engaging in physical activity. Therefore, this statement indicates a need for further home care teaching.
A client has cancer that has me tastasized to her bones. She is complaining of increased thirst, polyuria and decreased muscle tone. Her lab values are: Na 139mEq/L, k 4 mEq/L, Cl 103 mEq/L, and Ca 8 mg/dl. What electrolyte imbalance is present?
- A. Hypocalcemia
- B. Hyperkalemia
- C. Hypercalcemia
- D. Hypochloremia
Correct Answer: C
Rationale: The patient's symptoms of increased thirst, polyuria, decreased muscle tone, and the lab value of high calcium (8 mg/dl) indicate hypercalcemia. Hypercalcemia is commonly seen in cancer patients due to cancer metastasis to the bones, leading to the release of calcium. The other electrolyte levels (sodium, potassium, and chloride) are within normal range, ruling out other electrolyte imbalances. Multiple myeloma is a common malignancy associated with bone metastases and hypercalcemia. Symptoms of hypercalcemia may include thirst, frequent urination, weakness, confusion, and muscle pain. Treatment of hypercalcemia may involve hydration, loop diuretics, bisphosphonates, and addressing the underlying cause.
A child is brought to the emergency department experiencing an anaphylactic reaction to a bee sting. While an airway is being established, the nurse should prepare which medication for immediate administration?
- A. Diphenhydramine (Benadryl)
- B. Dobutamine (Dobutarex)
- C. Epinephrine (Adrenalin)
- D. Calcium chloride (calcium chloride)
Correct Answer: C
Rationale: In the management of anaphylaxis, the immediate medication of choice for administration is epinephrine. Epinephrine is a potent vasoconstrictor and bronchodilator which helps restore blood pressure and open up the airways during an anaphylactic reaction. It is the first-line treatment to reverse the potentially life-threatening effects of an allergic reaction. Other medications, like diphenhydramine or dobutamine, may be used as adjuncts later in the treatment, but epinephrine is crucial for immediate administration to stabilize the child's condition.
Which of the ff symptoms should a nurse assess in a client when implementing interventions for trauma to the upper airway?
- A. Pain when talking
- B. Increased nasal swelling
- C. Burning in the throat
- D. Presence of laryngospasm INFECTIONS OF THE LOWER RESPIRATORY AIRWAY
Correct Answer: D
Rationale: When implementing interventions for trauma to the upper airway, it is crucial for the nurse to assess for the presence of laryngospasm. Laryngospasm is a sudden spasm of the vocal cords that may cause difficulty breathing and in severe cases, complete airway obstruction. It is a serious and potentially life-threatening complication that can occur following upper airway trauma. Therefore, prompt recognition and treatment of laryngospasm are essential to ensure adequate oxygenation and ventilation for the client. Pain when talking, increased nasal swelling, and burning in the throat may also be symptoms encountered in upper airway trauma, but the presence of laryngospasm signifies a more critical condition requiring immediate intervention.